Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 995255 DEA: 041J9604 EFIS: 0414000403
QA Service Level: 1
DIST-CO-RTE-PM: 04-MRN-1-22.8/33.0,45.0/50.5
Work Description: COLD PLANE, RHMA, HMA, MGS, CURB RAMPS, SIDEWALKS, AND CULVERTS.
Location Description: MARIN COUNTY IN AND NEAR POINT REYES STATION FROM FIVE BROOKS TO 1.9 MILES NORTH OF CYPRESS ROAD AND IN AND NEAR TOMALES FROM 0.2 MILES SOUTH OF TOMALES TO 4.4 MILES NORTH OF TOMALES
Contractor Name: O.C. JONES & SONS, INC.
Contractor Address: Unknown
Resident Engineer: Andrew Wong Structure Rep.: Jeremy Light
DIME Sample ID: 2024-06-20-208
TL Number from the TL Form:
Sample Submitted By Organization: CT D04 - Richmond Field Laboratory
Sample Organization Contact: (510) 231-7151
Type of Sample: Quality Assurance
Type of Material: Hot Mix Asphalt
Sample Taken Date: 06/20/2024
Date that the sample was received by the laboratory/organization performing the testing: 06/20/2024
The quantity of what the sample constitutes: 5 Bags
A brief description of the sample: Aggregates
From where was the sample collected: Manufacturer
Laboratory sample identification: Rich_24_070
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Bodean - Santa Rosa
